Review

Vol. 21 No. 2 (2023): Blood Transfusion 2-2023 (March-April)

Transfusion of fibrinogen concentrate before dental extractions in patients with afibrinogenemia: a narrative review supported by a case report with a proposed treatment protocol

Authors

Key words: afibrinogenemia, hemorrhage, hemorrhagic disorders, hemostasis, tooth extraction
Publication Date: 2022-08-05

Abstract

Afibrinogenemia is a coagulation disorder that occurs with a frequency of 1-2 cases/1,000,000 population and is characterized by a lack of capacity to synthesize fibrinogen. The predominant symptoms related to fibrinogen deficiency are mucocutaneous bleeding, bleeding from the gastrointestinal tract, genital tract or other vascularized tissues as well as excessive bleeding after minor injuries or accidental cuts. Thromboembolic complications and impaired wound healing may also occur. Due to the rarity of the disease, there are no recommendations about fibrinogen substitution before dental procedures (including dental surgery). The purpose of this review is to discuss the indications for the transfusion of a coagulation factor in the preparation of a patient with afibrinogenemia for dental extraction. The article is a narrative review with a proposed management protocol for the dental procedure. The authors have included information from previously published case reports, research studies, and review papers as well as their own case report.

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Authors

Sylwia Czajkowska - Department of Conservative Dentistry and Endodontics, Poznan University of Medical Sciences, Poznan, Poland

Joanna Rupa-Matysek - Department of Hematology and Bone Marrow Transplantation, Poznan University of Medical Sciences, Poznan, Poland

Joanna Brzezińska - Dental Surgery Clinic at the University Centre of Dentistry and Specialised Medicine in Poznan, Poznan, Poland

Anna Surdacka - Department of Conservative Dentistry and Endodontics, Poznan University of Medical Sciences, Poznan, Poland

Lidia Gil - Department of Hematology and Bone Marrow Transplantation, Poznan University of Medical Sciences, Poznan, Poland

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